A Rare Case of Scrofuloderma Presenting as Recurrent Tuberculosis in a Young Patient

A 23-year-old Indonesian man was referred to our institution due to a skin ulcer with white exudate on the right chest wall. He had undergone treatment for pulmonary tuberculosis (TB) in Indonesia 3 years prior to the consultation. Chest ultrasonography and computed tomography revealed multiple intercostal abscesses and a thickened right pleura with calcification. Histological findings from a skin biopsy of the ulcer and a positive polymerase chain reaction for Mycobacterium tuberculosis in the exudate indicated the involvement of TB. Based on these findings, the patient was diagnosed with scrofuloderma and multiple intercostal abscesses. Recurrent TB may result from either the regrowth of residual strains or reinfection with a different strain. This report highlights that recurrent TB can manifest as scrofuloderma through contiguous spread from underlying intercostal abscesses. In cases of skin ulcers with an unclear aetiology, thorough histopathological and bacteriological assessments facilitate a prompt and accurate diagnosis.